Corneal Neurotization: Preoperative Patient Workup and Surgical Decision-making

Autor: Simeon C. Daeschler, MD, Jyh Haur Woo, MD, Isra Hussein, MD, Asim Ali, MD, FRCSC, Gregory H. Borschel, MD
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Plastic and Reconstructive Surgery, Global Open, Vol 11, Iss 10, p e5334 (2023)
Druh dokumentu: article
ISSN: 2169-7574
00000000
DOI: 10.1097/GOX.0000000000005334
Popis: Background:. The use of sensory nerve transfers to the anesthetic cornea has transformed the treatment of neurotrophic keratopathy by restoring ocular surface sensation and activating dysfunctional epithelial repair mechanisms. However, despite numerous reports on surgical techniques, there is a scarcity of information on the interdisciplinary management, preoperative assessment, and surgical decision-making, which are equally critical to treatment success. Methods:. This Special Topic presents a standardized, interdisciplinary preoperative workup based on our 10-year experience with corneal neurotization in 32 eyes of patients with neurotrophic keratopathy. Results:. Our assessment includes a medical history review, ophthalmic evaluation, and systematic facial sensory donor nerve mapping for light touch and pain modalities. This approach enables evidence-based patient selection, optimal surgery timing, and suitable donor nerve identification, including backup options. Conclusions:. Based on a decade-long experience, this special topic highlights the importance of interdisciplinary collaboration and provides a practical roadmap for optimizing patient selection and surgical decision-making in patients undergoing corneal neurotization.
Databáze: Directory of Open Access Journals